The latest cases occurred last month at the Veterans Affairs medical center in Los Angeles. Late Thursday, the Department of Veterans Affairs confirmed that the problem had occurred and said that an investigation into the matter was continuing.
“Our deepest sympathy goes out to the veterans affected by the Avastin eye injections,” it said in a statement.
Avastin, made by Genentech, is a cancer drug but is commonly used to treat the wet form of age-related macular degeneration and other eye diseases because it costs only about $50 an injection.
That saves Medicare and patients hundreds of millions of dollars a year compared with using Lucentis, a somewhat similar Genentech drug approved for the treatment of eye diseases but costing about $2,000 an injection.
To use Avastin for eye disease, a vial meant for a cancer patient must be divided into numerous tiny doses and each dose placed in a syringe for injection into the eye. The extra handling increases the risk of bacterial contamination and other problems.
On Tuesday, the Food and Drug Administration issued an alert saying that 12 patients in the Miami area had suffered eye infections after being injected with Avastin. Some of the patients lost all of the remaining vision in their treated eye, the F.D.A. said.
Earlier this year, four patients at the Veterans Affairs hospital in Nashville also suffered infections from the bacterially contaminated Avastin. The family of one man has filed a claim for $4 million, saying the infection left the man blind and with brain damage.
In the cases in Los Angeles, no contaminant has been identified, according to medical professionals and a patient involved. The five patients, who had macular degeneration, all received their injections of Avastin on Aug. 12 at the V.A. Sepulveda Ambulatory Care Center in the San Fernando Valley.
“We all ended up in the E.R. over the course of the next few days and put together the connection,” said the patient in Los Angeles. Most of the patients lost all of their vision in the eye that received the injection, he said.
This man, who said his vision had not recovered, spoke on the condition of anonymity because he and other patients were in talks with the V.A. about the situation.
He said he learned from V.A. officials that the drug had come from the pharmacy at the main campus of the V.A. Greater Los Angeles Healthcare System in Los Angeles.
The recent incidents could lead doctors and patients to use the far more expensive Lucentis instead of Avastin. In its statement, Veterans Affairs said that its Los Angeles medical center had suspended use of Avastin for macular degeneration on Aug. 15 and was now buying Lucentis to resume therapy for the 30 to 40 treatments it administers a week.
Some proponents of the use of Avastin say that there have been more than two million injections of the drug to treat eyes over the last six years with few problems.
The cases are also likely to raise questions about so-called compounding pharmacies, which prepare customized drugs for patients, including doses of Avastin to treat eye problems.
The F.D.A. has limited oversight of these pharmacies.
In its alert on Tuesday, the F.D.A. said the 12 cases of lost vision in Miami had been traced to a single compounding pharmacy, which it did not identify.
Article source: http://feeds.nytimes.com/click.phdo?i=fa81a0cb035ca4a242106a56fe9f0434